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Thursday, March 20, 2008

By Now, "Harm Reduction" Harms Both Science and the Public Health
Clinical Pharmacology & Therapeutics (2008); 83, 4, 513–514

There are few terms used in both the science and the public policy of drug abuse and addiction that are fuzzier or more controversial than "harm reduction." The most straightforward use of the term refers to public health or social policy strategies designed to reduce the negative consequences of drug abuse and addiction to an individual, his or her family, or the broader community in which addicted individuals live. For other people, however, "harm reduction" has over time become distorted into a euphemism for policies and programs that could increase drug use, such as legalization or decriminalization of drug activities. This ambiguity, coupled with the paucity of clear data on the effectiveness of most harm-reduction strategies, has led many people to hold—often with almost religious fervor—very strong positions for or against "harm reduction," however it is conceptualized. That ideology has prevented important science from being done and prevented the implementation of potentially successful social and public health strategies. This suggests that the term should be expunged from the jargon of our fields. It has taken on ideological meanings that get in the way of dealing successfully with serious drug problems around the world.
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